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NPI Code Detail

MEDICARE: ASHLEY IBRAHIM

MEDICARE: ASHLEY IBRAHIM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist

General Provider Information

NPI Number : 1093123366
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHLEY IBRAHIM
Provider Business Mailing Address
First Line : 2101 FAIRLAND RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-5427
Country : US
Telephone Number : 301-384-6161
Fax Number :
Provider Business Practice Location Address
First Line : 2101 FAIRLAND RD
Second Line :
City : SILVER SPRING
State : MD
Zip : 20904-5427
Country : US
Telephone Number : 301-384-6161
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2014
Last Update Date : 07/30/2014

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Directions to “ ASHLEY IBRAHIM ” Practice Location

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